Individual
DR. PETER N. LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
7717 N. ORANGE PRAIRIE ROAD, PEORIA, IL 61615
(619) 518-1506
(309) 589-6994
Mailing address
7717 N. ORANGE PRAIRIE ROAD, PEORIA, IL 61615
(619) 518-1506
(309) 589-6994
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
Primary
E3804
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E38040
—
CA
Enumeration date
06/09/2005
Last updated
03/27/2013
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